Here in the old USA and also in other countries there are companies that help people find affordable health care. The Surgery Center of Oklahoma is one of the premier and favorite destinations of those individuals needing surgery and those companies that help individuals find high quality and affordable care. Those seeking this care generally fall in to one of the following categories:
1)Uninsured here in the U.S.(this category also includes those with such high deductibles that they will be paying for the whole thing themselves).
2)Foreigners (mostly Canadians) not willing to wait on a list (usually years) to have their surgery within their broken-down socialized system
3)Foreigners whose home country has poor or unavailable care.
Let’s start with the easy one…#3. If you have money and you have a hernia, you would naturally travel to another place to have surgery if care was unavailable where you lived. This is perfectly understandable and no different than if you lived in a rural community and drove “to the city” to have your brain tumor evaluated by a neurosurgeon. We have had patients come to our surgery center from Africa because they had to travel anyway and they figured they might as well come to a place where they knew what it would cost.
Now let’s try to tackle #2. First of all, what does it mean that people who live in Quebec or Ontario or Vancouver or Montreal (big cities with every medical specialty and subspecialty represented) come to the Surgery Center of Oklahoma for their care? What sort of system is in place when an ear nose and throat surgeon whose office is across the street from your Vancouver town home (and who is not busy!!) is shunned for an ear nose and throat surgeon in Oklahoma City, thousands of miles away? What other evidence do we need that the Canadian styled system has failed? Are the Canadian doctors any good at what they do? Yes they are, without a doubt. Are they working hard? No. The Canadian government has limited what amounts of money can be spent on care (regardless of demand) so when the money runs out the physicians and hospitals stop working. ”There’s no more money for hernia surgery this year, Mr. Jones.” ”There’s no more money for coronary artery bypass surgery this year, Mr. Williams.” I have heard this story countless times. Compounding the problem is that the Canadian people have been brainwashed into thinking that their care is “free.” This combination of “free” care with deliberately stifled supply has caused such an imbalance of supply and demand that people are waiting in line for surgery. For years. Watch the video on our Media tab of the poor woman who came to Oklahoma City from Canada to have her hip replaced to get a feel for what she went through.
So, many of the Canadians come here. Some find us on their own. Some find us through brokers or companies that help these patients escape the wait. What effect has this competition had on the Canadian system? Not only have the wait times shortened for these patients due to the leak of surgical patients into the U.S.(and the incredibly bad press this has caused for the politicians in Canada), but the prices charged Canadians by the facilities along the border have fallen. Much of the revenue of hospitals on the U.S. side of the Canadian border come from Canadians willing to pay for their surgery in order to avoid the lines at home. The pricing at physician-owned facilities here in Oklahoma (hats off to the Oklahoma Heart Hospital and the McBride Clinic Hospital for helping their share of these folks!) like ours have made the prices more competitive along the border to the benefit of the Canadians, as these border hospitals count on this revenue and are not wanting to lose this business. I think this is a great example of how true competition disciplines the service providers to the benefit of the consumer.
Ok…ready for #1? This is the really hard one. Medical and surgical care in the United States is of fairly uniform quality no matter where you go. What? How can this be? Why would people travel from Alaska and Maine to Oklahoma City for their surgery then? Price. Guaranteed Price. The provision of quality care is not because of accreditation agencies or state health departments or federal rules and regulations. The delivery of quality medical care is the result of the small remnant of the free market that while whittled down and beaten down here in the U.S. still wields unimaginable power. If you are awful in this business you will go bankrupt, as it should be. Once you socialize care (government care) the worse you will become but ironically…..ready?…. the more money you make! What? Just look at any government program (including public schools and banks). The worse the performance the more money thrown at the problem. Not so in the private sector. If you want to find real quality and value look for places where there is real competition and a vital entrepreneurial spirit….that’s where you will find quality. Because the folks and facilities in that environment who are no good….well…they are already gone!…out of business.
The entrepreneurial spirit amongst physicians here in Oklahoma is alive and well. The care delivered in this part of the country is second to none because of the healthy competition within the medical community. The private practice, rugged individuality still prevalent here makes us all better than we would be were we practicing in an environment where the patients were captive and had to come see us and were without choices.
So…Maine….Alaska…Florida…California…good luck keeping up with us on the quality front. Until you post your prices, though, your facilities will continue to lose business to those of us who do post them and practice in a competitive environment.
G. Keith Smith, M.D.